Polymyxin B

Polymyxin B
Clinical data
Trade names	Poly-Rx, others
AHFS/Drugs.com	Monograph
Pregnancy; category	B;
Routes of; administration	Topical, intramuscular, intravenous, intrathecal, eye drops
ATC code	A07AA05 (WHO) J01XB02 (WHO) S01AA18 (WHO) S02AA11 (WHO) S03AA03 (WHO) QJ51XB02 (WHO);
Legal status
Legal status	In general: Over-the-counter (OTC);
Identifiers
	IUPAC name N-[4-amino-1-[[1-[[4-amino-1-oxo-1-[[6,9,18-tris(2-aminoethyl)-15-benzyl-3-(1-hydroxyethyl)-12-(2-methylpropyl)-2,5,8,11,14,17,20-heptaoxo-1,4,7,10,13,16,19-heptazacyclotricos-21-yl]amino]butan-2-yl]amino]-3-hydroxy-1-oxobutan-2-yl]amino]-1-oxobutan-2-yl]-6-methyloctanamide;
CAS Number	1405-20-5 ;
PubChem CID	5702105;
DrugBank	DB00781 ;
UNII	19371312D4;
ChEMBL	ChEMBL1201283 ;
NIAID ChemDB	007797;
CompTox Dashboard (EPA)	DTXSID5045839 ;
ECHA InfoCard	100.014.340
Chemical and physical data
Formula	C56H100N16O17S
Molar mass	1301.57 g·mol−1
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Polymyxin B, sold under the brand name Poly-Rx among others, is an antibiotic used to treat meningitis, pneumonia, sepsis, and urinary tract infections. While it is useful for many Gram negative infections, it is not useful for Gram positive infections. It can be given by injection into a vein, muscle, or cerebrospinal fluid or inhaled. The injectable form is generally only used if other options are not available. It is also available as the combinations bacitracin/polymyxin B and neomycin/polymyxin B/bacitracin for use on the skin.

Common side effects when given by injection include kidney problems, neurological problems, fever, itchiness, and rash. Injections into muscle may result in significant pain. Other serious side effects may include fungal infections, anaphylaxis, and muscle weakness. It is unclear if use during pregnancy is safe for the baby. Polymyxin B works by breaking down the cytoplasmic membrane which generally results in bacterial cell death.

Polymyxin B was approved for medical use in the United States in 1964. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. In Europe it is only approved to be applied to the skin as of 2015. It is derived from the bacterium Paenibacillus polymyxa (formerly known as Bacillus polymyxa).

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